A case of petrous apex cholesterol granuloma successfully treated with endoscopic endonasal surgery.

A transcranial approach in combination with a transpetrosal setting has been the mainstream of surgical treatment of cholesterol granulomas in the petrous apex. However, endoscopic endonasal surgery has become a choice of treatment for these lesions with recent advancements in surgical techniques and instruments. We report a successful case of cholesterol granuloma managed with endoscopic endonasal surgery.

Identification of the Babesia-responsive leucine-rich repeat domain-containing protein from the hard tick Haemaphysalis longicornis.

Haemaphysalis longicornis is a tick known for transmitting Babesia parasites, including Babesia gibsoni, in East Asian countries. The vector tick must have strategies to control Babesia parasites, while Babesia parasites are also considered to establish an evasive mechanism from the tick's innate immunity. Due to this mutual tolerance, H.

The postirradiation incidence of cavernous angioma is higher in patients with childhood pineoblastoma or primitive neuroectodermal tumors than medulloblastoma.

Purpose: The purpose of this study is to investigate the incidence of cavernous angioma (CVA) in long-term survivors of childhood embryonal tumors treated by cranial irradiation.

Materials And Methods: Between 1990 and 2012, we treated 25 patients (13 males, 12 females) with embryonal tumors (17 medulloblastomas, 5 primitive neuroectodermal tumors (PNET), 3 pineoblastomas) with craniospinal irradiation. Follow-up ranged from 15.

Visualization of regional cerebrospinal fluid flow with a dye injection technique in focal arachnoid pathologies.

Surgical lysis of the thickened arachnoid membrane is the first choice of treatment in spinal arachnoid pathologies that cause flow disturbances or blockage of CSF. However, it is important to consider that while extensive lysis of the arachnoid may temporarily provide a wide pathway for CSF, an extensive lytic procedure may later cause secondary adhesion. Thus, it is ideal for the proper extent of the arachnoid lysis to be determined after careful analysis of regional CSF flow.

A case of transient hypothermia after trans-lamina terminalis and third ventricle clipping of an extremely high-position basilar tip aneurysm.

Reports on the trans-lamina terminalis and trans-third ventricular approach are rare. The risk associated with this approach is unknown. After an unsuccessful endovascular surgery, we performed direct surgical clipping via the third ventricle on a 78-year-old woman presenting with an extremely high-positioned, ruptured basilar tip aneurysm.

Usefulness of dual protection combined with blood aspiration for distal embolic protection during carotid artery stenting.

Background: We describe dual protection (simultaneous flow reversal and distal filter) combined with blood aspiration as a novel technique to provide distal embolic protection during carotid artery stenting (CAS).

Methods: Between July 2011 and August 2014, 190 patients with internal carotid artery (ICA) stenosis underwent 190 CAS procedures as follows. After post-dilation of the stent using dual protection, the aspiration catheter was placed between the distal filter and the proximal end of the stent, and the blood was aspirated several times from the ICA.

A craniopharyngioma with spontaneous involution of a gadolinium-enhanced region on magnetic resonance imaging.

Background: It has not been reported previously that the solid enhancing portion of a craniopharyngioma has involuted without a change in cyst size.

Case Description: We herein report a case of a craniopharyngioma with spontaneous involution of a solid gadolinium (Gd)-enhanced region on magnetic resonance imaging (MRI). A 44-year-old female was referred to our department with a mass on MRI associated with headaches and polyuria.

Regression of dural arteriovenous fistulae after venous flow reconstructive surgery in a case with hemangiopericytoma at the confluence of sinuses.

Background: The mechanism by which acquired dural arteriovenous fistula (dAVF) develops is still unclear. Few cases have been reported with both dAVF and intracranial tumors, and in these few cases the authors have proposed that induced venous hypertension may lead to the pathogenesis of dAVF. We experienced a case of intrasinusoidal hemangiopericytoma (HPC) with dAVF development.

Tricuspid regurgitation resulting from acute type A aortic dissection.

Proximal extension of acute type A aortic dissection can affect the aortic valve but seldom affects the tricuspid valve. We report the case of an octogenarian who underwent successful surgical repair of an aortic dissection that was accompanied by tricuspid regurgitation. We believe that the tricuspid regurgitation was attributable to displacement of the valve resulting from aortic dissection.

Kruppel-like factor 4 expression in osteoblasts represses osteoblast-dependent osteoclast maturation.

Kruppel-like factor 4 (KLF4) is a zinc-finger-type transcription factor with a restricted expression pattern during skeletal development. We have previously shown that KLF4 represses osteoblast mineralization concomitant with a down-regulation in the expression of a number of osteoblastic genes, both in vivo and in vitro. In addition to the cell-autonomous effects of KLF4 in osteoblasts, transgenic osteoblastic-KLF4 mice show severe defects in osteoclast maturation.

Intraoperative cortico-cortical evoked potentials for the evaluation of language function during brain tumor resection: initial experience with 13 cases.

Objectives: The objective in the present study was to evaluate the usefulness of cortico-cortical evoked potentials (CCEP) monitoring for the intraoperative assessment of speech function during resection of brain tumors.

Methods: Intraoperative monitoring of CCEP was applied in 13 patients (mean age 34 ± 14 years) during the removal of neoplasms located within or close to language-related structures in the dominant cerebral hemisphere. For this purpose strip electrodes were positioned above the frontal language area (FLA) and temporal language area (TLA), which were identified with direct cortical stimulation and/or preliminary mapping with the use of implanted chronic subdural grid electrodes.

[Intradural arachnoid cyst associated with syringomyelia: a case report].

An intradural arachnoid cyst is a relatively rare condition, occurring within the spinal subarachnoid space. We present the even-more rare case of an intradural arachnoid cyst associated with syringomyelia at the same spinal level. The patient was a 66-year-old man who presented with bilateral leg numbness and gait disturbance.

[Selective coil embolization of a distal anterior choroidal artery aneurysm associated with moyamoya disease: a case report].

Intracranial hemorrhage in patients with moyamoya disease is often caused by rupture of the associated aneurysms. Of these aneurysms, distal anterior choroidal artery (AChoA) aneurysms are rare. In patients with moyamoya disease, the AChoA constitutes collateral vessels and the aneurysm requires careful treatment strategy.

Neuroimaging diagnosis of pineal region tumors-quest for pathognomonic finding of germinoma.

Introduction: Our study aimed to elucidate the imaging features for the differentiation of pineal germinoma and other pineal region tumors.

Methods: Image data sets of computed tomographic (CT) scan and magnetic resonance imaging (MRI) data of 93 pineal region tumors including 33 germinomas, 30 nongerminomatous germ cell tumors (NGGCTs), 20 pineal parenchymal tumors (PPTs), and 10 miscellaneous tumors of pineal region were reviewed. Imaging features on CT and MRI were qualitatively assessed by three readers.

A multicenter phase I/II study of the BCNU implant (Gliadel(®) Wafer) for Japanese patients with malignant gliomas.

Carmustine (BCNU) implants (Gliadel(®) Wafer, Eisai Inc., New Jersey, USA) for the treatment of malignant gliomas (MGs) were shown to enhance overall survival in comparison to placebo in controlled clinical trials in the United States and Europe. A prospective, multicenter phase I/II study involving Japanese patients with MGs was performed to evaluate the efficacy, safety, and pharmacokinetics of BCNU implants.

Functional plasticity of language confirmed with intraoperative electrical stimulations and updated neuronavigation: case report of low-grade glioma of the left inferior frontal gyrus.

Removal of glioma from the dominant side of the inferior frontal gyrus (IFG) is associated with a risk of permanent language dysfunction. While intraoperative cortical and subcortical electrical stimulations can be used for functional language mapping in an effort to reduce the risk of postoperative neurological impairment, the extent of resection is limited by the functional boundaries. Recent reports proposed that a two-stage surgical approach for low-grade glioma in eloquent areas could avoid permanent deficits via the functional plasticity that occurs between the two operations.

Gowers' intrasyringeal hemorrhage associated with Chiari type I malformation in Noonan syndrome.

Background: Idiopathic hemorrhage in a syrinx is a rare entity known as Gowers' intrasyringeal hemorrhage. Bleeding confined to the syrinx cavity causes severe, sometimes acute, neurological deficits. We report a case of intrasyringeal hemorrhage into a preexisting lumbosacral syrinx associated with Chiari type I malformation.

[Anti-emetic effect of granisetron in patients undergoing cranial and craniospinal radiotherapy].

Purpose: Approximately 30-59% of patients undergoing cranial or craniospinal radiotherapy experience nausea and/or vomiting. Here, we evaluated the effectiveness of granisetron for controlling emesis in patients treated with cranial or craniospinal radiotherapy.

Patients And Methods: Between December 2011 and January 2013, 34 patients(19 males, 15 females;age range, 3-80 years)received cranial or craniospinal radiotherapy at our department.

Neuroanatomic pathway associated with attentional deficits after stroke.

We used magnetic resonance imaging (MRI) and the statistical parametric mapping (SPM) image analysis technique to localize lesions in post-stroke patients with attention deficits. SPM can be used to combine image data from multiple participants and correlate these images with other data sets. Magnetic resonance imaging acquisitions were obtained from 115 post-stroke patients, who were systemically assessed for attention deficits using a standardized test (the Clinical Assessment for Attention; CAT) that probes various domains of attention.

A Multicenter Phase I/II Study of the BCNU Implant (Gliadel Wafer) for Japanese Patients with Malignant Gliomas.

Carmustine (BCNU) implants (Gliadel Wafer, Eisai Inc., New Jersey, USA) for the treatment of malignant gliomas (MGs) were shown to enhance overall survival in comparison to placebo in controlled clinical trials in the United States and Europe. A prospective, multicenter phase I/II study involving Japanese patients with MGs was performed to evaluate the efficacy, safety, and pharmacokinetics of BCNU implants.

Postoperative fever specific to neuroendoscopic procedures.

The most common complication of neuroendoscopic surgery is postoperative fever without infection, although the details have not been discussed. The objective of this study was to clarify the clinical features and predicting factors of the postoperative fever following neuroendoscopic procedures. Between March 1998 and March 2013, 83 patients (46 males, 37 females; median age, 14.

[Transorbital penetrating intracranial injury by a chopstick: a case report and review of the literature].

This 4-year-old girl fell while holding plastic chopsticks and a chopstick penetrated her left eye. The chopstick was removed immediately by herself. Conventional CT and MR images showed a penetration track from the orbital roof to the basal ganglia.

Impact of subclinical haemorrhage on the pituitary gland in patients with pituitary adenomas.

Objective: Advanced magnetic resonance imaging (MRI) and optical instruments for surgery frequently demonstrate subclinical haemorrhage in pituitary adenomas; however, the effects of subclinical haemorrhage on pituitary glands remain unclear. We sought to clarify the pituitary function in patients with subclinical pituitary adenoma haemorrhage (SPAH).

Design/patients: Between January 2006 and December 2012, we retrospectively reviewed 328 consecutive patients who underwent surgery for pituitary adenoma.

[A case of solitary fibrous tumor in the sella turcica].

A 64-year-old male presented with an incidental tumor in the sella turcica during a brain medical checkup. Because he lacked any neurological symptoms or signs of pituitary dysfunction, the patient did not undergo surgery. Three years later, visual disturbances developed, including poor eyesight and visual field defects.

Electrocorticographic-histopathologic correlations implying epileptogenicity of dysembryoplastic neuroepithelial tumor.

Based on intracranial-video electroencephalography (EEG), histopathological features, and postoperative seizure outcome, we elucidated the epileptogenicity in patients with dysembryoplastic neuroepithelial tumor (DNT). Five patients (P1-P5) pathologically diagnosed with DNT underwent intracranial-video EEG to identify the ictal onset zone and irritative zone. We evaluated the correlations of ictal onset zone and irritative zone with the magnetic resonance imaging-visible lesion (MRI-lesion) and their histopathological features.